Gout is a condition caused by elevated levels of uric acid in the body. If levels are high enough, uric acid can end up crystallising in one or more joint, which typically causes intense pain and inflammation. Gout quite often affects the ball of the foot (the major joint of the big toe), but the condition can affect any joint. Conventional medical treatment is centred on painkillers for attacks of gout, as well as drugs (e.g. allopurinol) that can lower uric acid levels by speeding its elimination from the body through the kidneys (known as having a ‘uricosuric’ affect).
However conventional drugs are apparently not the only agents which have a uricosuric effect. Previous studies have found, for instance, that vitamin C also does this [1-4]. And recently saw the publication of a study which assessed the relationship between vitamin C intake and risk of gout in almost 47,000 men [5]. All the men had no history of gout when they entered the study. Their intakes of vitamin C (via diet and supplements) were assessed every 4 years over a 20-year period.
Risk of gout was found to be lower in individuals with higher vitamin C intake. Compared to individuals with a total vitamin C intake of less than 250 mg per day, those with total intakes of 500-999 mg per day were at a 17 per cent reduced risk of gout. For intakes of 1000-1499 and 1500 or more mg per day, risk of gout was down by 34 and 45 per cent respectively.
The authors of this study also looked at the relationship between amounts of vitamin C ingested in supplement form only and risk of gout. Here again, higher supplemental levels were associated with a reduced risk of gout. Compared to those who did not supplement with vitamin C, those supplementing with 1000-1499 and 1500 mg or more of vitamin C per day were found to be at 34 and 45 per cent reduced risk of gout.
These results suggest that vitamin C, either from diet and/or supplements, is associated with a reduced risk of gout. This study is epidemiological in nature, and cannot be used to conclude that vitamin C reduced the risk of gout. However, the fact that vitamin C is known to be uricosuric does make a genuine protective effect likely.
Another piece of research which provides further supporting evidence for this is a randomised controlled trial in which individuals were treated with 500 mg of uric acid or placebo (inactive medication) over a 2-month period [6]. Vitamin C, compared to placebo, led to a statistically significant reduction in uric acid levels (the average fall in uric acid levels in this study was 0.5 mg/dL which is equivalent to about 30 micromols/litre).
Put together, these results suggest that vitamin C has real potential to help prevent gout. My tendency in practice is to use doses of about 2000 mg per day (as 1000 mg taken twice a day). Individuals who should consult their doctor before supplementing with vitamin C include those with the condition glucose-6-phosphate dehydrogenase deficiency, those suffering from conditions in which iron levels are elevated in the body such as haemosiderosis or haemochromatosis (vitamin C enhances iron absorption), and those with a history of kidney stones or kidney failure.
References:
1. Stein HB, et al Ascorbic acid-induced uricosuria: a consequency of megavitamin therapy. Ann Intern Med 1976;84:385-8
2. Sutton JL, et al Effect of large doses of ascorbic acid in man on some nitrogenous components of urine. Hum Nutr Appl Nutr 1983;37:136-40
3. Berger L, et al. The effect of ascorbic acid on uric acid excretion with a commentary on the renal handling of ascorbic acid. Am J Med 1977;62:71-6
4. Mitch WE, et al. Effect of large oral doses of ascorbic acid on uric acid excretion by normal subjects. Clin Pharmacol Ther 1981;29:318-21
5. Choi HK, et al. Vitamin C intake and the risk of gout in men: a prospective study. Arch Intern Med. 2009;169(5):502-7.
6. Huang HY, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005;52(6):1843-7
Two friends of mine in USA with gout started taking cherry juice – cherries out of season – and have found that their gout has definitely reduced. They said that gout was a form of arthritis? The cherry farmers in USA have been banned from saying that cherries are a known way to ease gout. The drugs companies have got their claim banned, even tho its known that cherries have something that eases gout. Wonder if its the Vit C that does this?
I’d also heard that specific claim for cherries. Couldn’t test that or the vitamin C theory though as mother hasn’t had an attack since her felodipine was stopped and her furosemide changed to bumetanide, something about that combination seemed to be the triggering factor.
Could you please explain how many men in one hundred would have had an epsiode of gout in each of the following groups of the Choi et al study?
< 250 mg/d
500 to 999 mg/d,
1000 to 1499 mg/d
1500 mg/d or greater
It might help your readers to better understand the overall and relative levels of risk.
If the uric acid level increases and would result to gout, then is it possible that you have to drink a lot of water t avoid these kind of a disease before it will takes places?
I think that will be better for those who wanted to avoid the risk of having this kind of a disease. But for those who suffer from it, well, your post which concerns with healing gout and other precautionary measures will do.
I’ve read some articles related to this study. Is it correct to say that the study is rather inconclusive? Initially, I read that Vitamin C inhibits the production of uric acid and therefore helps gout in that manner.
However, recently I’m also seeing that Vitamin C supposedly helps the kidneys reabsorb uric acid from the blood, thereby allowing greater excretion of uric acid through the urine.
I also read a post that states that vitamin c inhibits the liver from producing uric acid due to fructose (I didn’t know fructose triggered the production. I thought it was just purines.)
That means there are three different ways vitamin C helps with gout. Is my understanding about right?
In any case, I’ve started taking up to 2000 MG of Vitamin C per day. Who knows? Maybe it’ll lower my uric acid level.
This is good to know about Vit. C. I hadn’t seen it mentioned much in my research on gout. To comment on the message above as to what cherries do, they are rich in compounds that prevent the destruction of collagen, which the body uses to form connective tissue. The connective tissue is damaged by gout. Cherries also have an enzyme that neutralizes uric acid and cherries are high in anthocyanins which have high antioxidant properties as well as anti-inflammatory action. There are many natural substances that can help sufferers of gout. I like Burdock Root, for instances, and many people have said it helps them.